2015 Healthcare Analytics Summit™: Wednesday Recap

September 9th was the first full day of presentations for the 2015 Healthcare Analytics Summit (HAS) in Salt Lake City. The second annual event started with a welcome from Health Catalyst CEO Dan Burton. In typical Heath Catalyst fashion, Dan Burton kicked off HAS not by talking about Health Catalyst or even about the conference itself, but by thanking and talking about the attendees.

We were treated to pre-Summit survey results taken from attendee responses in the HAS’15 app. Turns out the summit audience consisted of more people in clinical positions than last year and most of the audience had over 20 years of experience in the healthcare industry. Additionally, this was an audience who answered that they wanted to take a proactive approach to risk-based contacting. Good thing because the summit is packed full of more than 80 case studies of health systems using data and analytics to improve outcomes.

Another survey result showed that the majority’s favorite Pixar movie (in honor of one of tomorrow’s keynote speakers, Ed Catmull) is Toy Story. Naturally, that led into showing a scene from the original movie of Woody’s frustration with Buzz Lightyear for not understanding that he was merely a toy. The clip ended with Buzz’s memorable line, “You are a sad, strange, little man.”

Have we all felt frustration similar to Woody’s when we are trying to use data to tackle some important healthcare problem? This was the question Dan posed to the audience to get everyone in the right mindset for the next two days.

As a note of encouragement, he stated that analytics-based breakthroughs are possible, but that we need long-term, sustained commitments to deliver the necessary outcomes for individual initiatives. Dan pointed out that meaningful shifts from volume to value will begin to impact our organizations over the next few years. The age of analytics is arriving.

During the Summit, attendees will be treated to many presentations from healthcare systems across the world that are using analytics to systemically improve outcomes. It is Dan’s hope that everyone will be able to learn what these systems are doing and deploy this education at their home organizations.

Keynote: The Moneyball Philosophy: Bringing Analytics to the NBA

Daryl Morey, Houston Rockets General Manager

Healthcare isn’t the only industry that needs good data to succeed. Daryl Morey, General Manager of the Houston Rockets, showed how analytics helped the Houston Rockets reveal hidden talent and win big in the NBA. He kicked off his presentation telling the audience he’s been called a pioneer, a rock star, a nerd, a geek, and the poster boy for basketball analytics. Morey explained he discovered analytics at a young age thanks to Bill James, the man who invented sabremetrics for baseball.

Daryl created a data-driven culture and put the analytics behind the saying, “the best offense is a good defense.” Daryl used analytics to target opponents’ biggest threats (think Kobe Bryant of the Lakers) and discovered his team’s unlikely aces (think can’t-make-a-free-throw Shane Battier of the Rockets), demonstrating that, sometimes, the best players on the best teams don’t have anything to do with winning the game.

In the Rockets’ case, “no stats All Stars” like Shane Battier were the key game-winning factors. Shane took an avalanche of data, interpreted it, and put it to work on the court. Daryl encouraged the audience to use data to identify and recognize their organizations’ no-stats All Stars, and prioritize creating a data-driven culture that studies how all factors contribute to success or failure; not just top performers. Because most of the time, as we all learned from his experience in the NBA, blocking two bad shots is better than making one good one.

Some other key principles Daryl shared regarding analytics:

Get buy-in from leadership. And if you have the data to support the arguments, it makes buy-in that much easier.

When you have a key decision to make, know when to use experience and intuition versus data. Experience and intuition are data unto themselves; just not as quantifiable.

If you have a lot of data that’s highly predictive of outcomes, then analytics should drive the decision. But when data is highly variable and has limited predictive power, intuition and experience should drive the decision.

Data gives you two things: it gets you to ask the right questions and it gives you the confidence to make major investments.

Morey said his biggest challenge was convincing the players and coaches that data isn’t intimidating. He told them relevant, timely statistics, combined with their expertise and experience, would have a positive impact on their play as well as the play of the entire team.

The bottom line, Morey said, is that sports are about decisions making, and the science shows over and over that if you use objective data and analysis in decision making, you make better decisions.

Keynote: Greatness in Turbulent Times

Jim Collins, Best-selling Author of Built to Last, Good to Great, and Great by Choice

Best-selling author Jim Collins’s passion for helping individuals and organizations grow into greatness is undeniable. What distinguishes the great organizations from the merely good? How do they react when hit by unforeseen events that are impossible to control?

Jim’s 90-minute, wisdom-infused motivational talk took the audience on a journey through questions every company should ask themselves, revealing tangible advice honed from real experiences inside and outside healthcare:

Be humble: Effective leaders are humble. Make it about the cause, not you.

Do great work: Focus on your unit of responsibility, not your career: Make everything you do a pocket of greatness.

Face the brutal facts: Make decisions using analytics, even if they reveal unpleasant realities.

Be focused: Great leaders distill the complex world down to a single, focused, and effective idea.

Consistency is key: True discipline is consistency of action. Avoid the signature of mediocrity: chronic inconsistency.

The genius of “and”: Great leaders say “and” instead of “or.” It is possible to preserve your core values and stimulate progress to adapt to inevitable changes.

Luck favors the persistent: Life is a series of hands. Great leaders stay in the game. They play every hand-good or bad-to the best of their ability.

Jim told the story of two North Pole explorers who, despite facing the same circumstances, experienced drastically different results, Robert Falcon Scott and Roald Amundsen. Amundsen’s team reached the Pole first and all returned home safely. Scott’s team reached the Pole 34 days later. All five members of Scott’s Pole team perished, just 11 miles from a supply depot.

Amundsen achieved greatness through persistence and consistency, one 20-mile march at a time. Scott, however, would drive his team to exhaustion on good days and make little to no progress on days when the weather was bad.

Jim’s parting wisdom to the audiences was to, despite the myriad of healthcare-related challenges they face every day, stay in the game, be persistent, and continue their 20-mile marches toward greatness.

Collins also shared the interesting stat of the day: 18% of the Gross Domestic Product (GDP) of the most dynamic economy in history is devoted to healthcare…and no one is happy! Jim says we cannot settle for healthcare being good or good enough. It’s our economic or moral imperative to make healthcare great, which is difficult to do when things are pretty good.

Keynote: Delivering Excellence at Stanford Health Care

His first poll question was “Who thinks conference badges are getting too big?” And when the CEO of a $3 billion academic healthcare system cited Flavor Flav (the rapper) and Seinfeld (the comedian) within the first few minutes of his presentation, the audience knew they were in for an entertaining experience. Amir Dan Rubin didn’t disappoint. He spoke about Stanford Health Care’s strategy to deliver leading edge and highly coordinated care across four domains: Complex Care, Network of Care, Accountable Care, and Virtual Care while delivering on the mission: Healing humanity, through science and compassion, one patient at a time.

Amir pointed out that anybody can have a strategy; the trick is executing it. Stanford uses analytics to improve processes and reinforce its goal to deliver the best patient experience anywhere, period. It’s doing something right; its patient experience scores are in the 95th percentile in the nation and number one in the Bay Area.

Wednesday Breakouts at the 2015 Healthcare Analytics Summit

In addition to the amazing keynote presentations, there were some breakout sessions that truly wowed.

The Healing Power of Data

Dr. Bridget Duffy, opened her presentation by sharing an experience from her residency. She was caring for patient who was recovering from heart surgery. Clinician after clinician entered the room and took the chart from her hands.

“Each clinician reviewed the chart, tweaked the machine that dealt with the patient’s broken body parts, and left,” Dr. Duffy said. “No one spoke to or touched the patient.”

It was then Dr. Duffy realized that it wasn’t her patient who was diseased and fragmented, it was the system.

“We’ve been so focused on process improvement and stripping out waste. However, evidence points to the human experience as a key driver for patient and staff satisfaction,” Dr. Duffy said.

Dr. Duffy said successful healthcare organizations integrate traditional approaches to patient care with a focus on trusted relationships and compassionate care. She closed her presentation by sharing her belief that healthcare organizations will hardwire human-centered innovations to design better experiences for patients, families, and staff. Clinicians, using data and analytics, will identify gaps in communication and performance and will be able to address employee and patient dissatisfaction more quickly.

Health Analytics: Driving and Being Driven by Profound Change

Vi Shaffer has seen a lot of changes in her 40+ years in healthcare. But in her presentation today she said that the changes underway today are the only truly profound changes in the structure of healthcare in her lifetime. The transformation includes not only value-based care and other elements of health reform but medical advances that have extended the average lifespan. In an increasingly complex environment, many healthcare organizations have tried to preserve profitability through continuous growth. The business transformation has encouraged the rise of population health management. CEOs increasingly are focusing on consumer engagement in an effort to build brand loyalty, with improving the patient experience now a top priority. Data is the key to new strategies for improving the patient experience. Meanwhile, physicians are increasingly frustrated and overwhelmed by the pace of change. In response, CMIOs are focusing on change management and better analytics. The combination of Big Data, remote biometrics, and advanced analytics is quickly creating a real-time healthcare system. Personalized, precision medicine and technology that puts diagnostic data in the hands of patients means clinicians are becoming strategic partners with patients to guide them through health changes. Amid all this profound change, healthcare professionals need to be the leaders to help people change; we have to be impatient for the future, rather than resistors.

Cincinnati Children Hospital, one of the largest pediatric providers in the country, believes that while each patient is unique the processes used to care for them shouldn’t be. Dr. Ryckman, Senior Vice President of Medical Operations at the hospital, summarized Cincinnati Children’s ultimate goal: to match the patient with the right provider on the right floor in the rights bed with the right team. The hospital has been able to accomplish this goal using real-time, predictive analytics to standardize key care processes, reduce costs, and eliminate waste.

How Mayo Clinic Standardized Care Across 22 Emergency Departments

Dr. Russi from the Mayo Clinic shared how he was tasked with integrating care for 22 emergency departments of varying size, demographics, location, and abilities. This was a task he took on despite not having comprehensive data and analytics at his disposal. The message was don’t be paralyzed by a lack of analytics, there is still a lot that can be done. Dr. Russi showed how important it is to balance standardization with flexibility to deliver true “artful” medicine. And his success in replacing the temporary ER physicians with physicians, NPs, and PAs who are employed by Mayo and who buy-in to the vision, mission, and culture. Hiring the right people is an integral step in standardizing and integrating among several departments.

How One Pioneer ACO Is Improving Healthcare Performance Through Analytics and Cultural Transformation

“Are we making decisions based on data?” That was the question that leaders at OSF HealthCare, an 11-hospital integrated health system based in Peoria, Illinois, asked themselves as they prepared to take on the challenge of the Pioneer ACO program. They discovered that the answer, more often than not, was, “No.”

In this session, OSF’s analytics experts shared their journey toward creating an effective system for using data to drive decision making. They knew that establishing an analytics infrastructure and effecting cultural change would be critical to success. Three key areas of focus were therefore:

Implementing an electronic data warehouse (EDW)

Providing tools and transparency to engage leadership

Forming and supporting multidisciplinary improvement teams

Each of these areas required an iterative process. “There was no Big Bang,” Mark Hohulin explained. Instead, the team focused on quick wins that would drive internal support and investment.

Roopa Foulger assured the audience that building a data-empowered culture isn’t easy, but it is possible. OSF has established a culture based on transparency and collaboration—which, in turn, ensures accountability and combined focus.

With this cultural transformation occurring, OSF has more tightly aligned its priorities, quality measures, and action plans with specific improvement goals. As a result, the organization earned $4.9M in shared savings in its third year as a Pioneer ACO. This foundation of improvement will be essential as OSF pursues its “audacious goal” (as part of the Health Care Transformation Taskforce) of having 75% of its population under a value-based arrangement by 2020.

One of the more memorable moments from Kathleen Carberry’s presentation was when she stated that quality is a contact sport. Also, that you can’t chase the bottom line, you have to chase quality. Texas Children’s Hospital (TCH) performs 1,100 appendectomies a year. For an outcomes improvement specialist who was accustomed to dealing only with rare diseases, Kathleen Carberry had to scale up what she’d been doing in the past in order to improve surgical outcomes for this high-volume procedure. The first poll question of the day revealed a lot about why TCH needed these improvements. 36% of respondents said it takes 4 to 6 hours for patients to get from their emergency centers to the OR for an appendectomy. At TCH, the time range was 12 to 16 hours, so they knew they had some really big opportunities for increasing efficiencies.

Her research showed that the mean length of stay (LOS) for appendectomy procedures varied significantly based on a number of factors, including severity of appendicitis, operating room availability, surgeon preferences, nursing policies, and hospital systems. TCH recognized the need to reduce this variation and improve quality of care while reducing costs. They introduced four tools into their system to help achieve these goals: a Late-Binding™ Data Warehouse; an advanced analytics application; permanent, integrated workgroup teams; and evidence-based best practices. These were rolled out using a three-systems approach: an analytics system, a deployment system, and a content system. The results have been astounding, among them a 36% reduction in post-op LOS, a 19% decrease in time from diagnosis to surgery, and a 19% reduction in average variable direct costs. Looking forward, TCH now knows how vital it is to build relationships among stakeholders and the multi-disciplinary teams, all led by a physician champion and driven by data that provides a single source of truth.

Is Big Data a Big Deal…or Not?

Dale Sanders answered the question, “will Big Data be a big deal for healthcare?” with a resounding, “Yes! But not quite yet.” He spoke of the importance of courage and a good culture as healthcare becomes more of a “technology-enabled services industry.” The biggest takeaway was that the entire C-suite must know about technology now, not just the CIO.

As risk-based contracts become more common, the need for healthcare organizations to deliver high-quality, safe care with minimum waste will grow. Providers that take on risk in the accountable care environment must focus on developing care management programs for high-need high-cost patients to maintain quality while minimizing costs. Lessons learned by Partners HealthCare in its own adventures in risk-based contracting include:

Know what business and clinical questions you should answer with analytics. Clear focus on specifically defined business and clinical goals using targeted improvement strategies is critical.

Involve the right people. Medicine is increasingly a team-based endeavor. Successful quality improvement requires engaging the right people with the right skillsets.

Take a rapid-cycle failure and improvement approach. Implement an iterative approach to improvement that fosters collaboration. View failures as opportunities to improve.

Data is not enough–you need to build clinical programs that take advantage of the insights garnered from the data. The system should be designed to disseminate insights gleaned from the data and best practices to achieve and sustain improvements.

Building these self-service tools can become overwhelming for the organization. Carefully design and deploy analytics applications to avoid overwhelming the organization. Education of end-users is critical.

The session kicked off with a poll question: Does your organization currently share predictive analytics results with patients? The answer was a resounding no (91% of respondents).

“That’s exactly what I always said … until just recently,” said Greg Spencer, Crystal Run Healthcare CMO. Crystal Run has embarked on a pioneering effort to assess patient risk—and to then use that insight to engage and activate patients. The organization’s ability to educate patients using predictive analytics is so new that the application is still in beta testing.

Lou Cervone, Director of Business Intelligence, took the stage to review how they developed their predictive analytics algorithm. He then showed the application interface that clinicians can present to patients. It includes:

The patient’s current risk score

Average yearly cost and out-of-pocket cost for the patient

Current complications

What’s next if patient’s current condition and lab results continue as is

Simulations (e.g., If you change X, how will that affect your risk score and cost?)

Care recommendations

The patient flight path: a linear representation of the patient’s risk. Patients can see the flight path go up or down as they check or uncheck the recommendations.

The jury is still out as to how much Crystal Run’s application will succeed in helping modify patient behavior. But the concept is clearly of great interest to other healthcare organizations: 97% of attendees responded that they could see their organizations adopting such an application.

How a Pioneer ACO Is Using Analytics to Improve the Management of Heart Failure

Allina Health improved 30-day heart failure readmission rates in 10 of its 11 hospitals by starting small. Dr. Spencer H. Kubo, Allina’s Chief Medical Officer, emphasized the importance of starting small when it comes to analytics-based improvement projects. By focusing on a targeted improvement goal first Allina was able to demonstrate early success and motivate the behavior change required to make significant improvements.

Using a late-binding EDW and heart failure dashboard, Allina monitored, measured, and managed performance while driving system-wide behavior change. It identified a physician champion to ensure improvements would be effective, sustainable, and benefit each patient. And it encouraged all involved in the care of patients with chronic diseases to look beyond their individual roles to identify gaps in care and improve care coordination. By starting small, Allina made big improvements in its management of heart failure.

Entering Shared Risk for Community Hospitals Through Physician Engagement

As a community hospital, Thibodaux Regional Medical Center has historically used lean principles to wring out cost and achieve improvement. Formerly done by in-house staff with little physician involvement, the administration has engaged more with the physicians within the last year, and it is changing Thibodaux’s culture for the better.

CEO, Greg Stock, explained as Thibodaux attempts to enter to enter the shared-risk market it is critical to bridge any gap in trust between the affiliate physician-lead groups and the administration.

Empowering clinicians to lead the improvement process, Stock said Thibodaux has already realized improvements in early recognition of septic patients. Mortality rates nationally are 14 percent. Thibodaux has reduced their sepsis mortality rate to 11 percent and is poised to reduce the rate by another 25 percent; truly demonstrating a “never satisfied” improvement culture.

Dr. Mark Hebert shared the methodology his team of physicians use to more readily and easily collaborate with senior leaders. He stressed the critical need for trust and engagement between the administration and physicians. The success they have achieved was shared with the rest of the organization and served as the first step to creating a culture of continuous improvement.

Both men closed their presentation telling the audience the relationships between senior leadership and physicians are healthier than they have been allowing for more collaboration, alignment of incentives, and team building. This has led to positive returns for Thibodaux, including hard and soft cost savings, improved patient care, and positive cultural change.

Panel: Children’s Hospitals: “Tike-mares”…Are the Monsters Under the Bed Real?

What is your “tikemare?” That was the first question posed to this panel of four great minds in the pediatric healthcare data and quality profession. The clear theme among the responses was the paucity of clinical evidence available to provide answers to many of their quality questions, including the yawning chasm in national long-term outcomes measures. David Bertoch, Vice President of Comparative Data and Informatics at Children’s Hospital Association, cited the lack of timeliness and the need for better data collection methods. Dr. Charles Macias, the Chief Clinical Systems Integration Officer at Texas Children’s Hospital, expressed his concerns that the volume of healthcare data will double over next five years, so we’ll have an entire generation of people who expect to see data in order to make informed healthcare decisions. Dr. Spahr, the Chief Quality Officer at Children’s Hospital of Wisconsin, questioned whether children’s hospitals nationwide would be able to partner effectively to establish outcomes measures.

The panel experts were asked how they’ve gone about finding support for their initiatives. Dr. Eugene Kolker, the Chief Data Officer at Seattle Children’s Hospital, said his organization is going through a cultural change that starts with people, then process, then technology. He says to start small, nail it, then scale it (a nice sound bite for all participants to take home with them).

The responses to this poll question provided some answers:

The most important factor for the future of pediatric healthcare delivery is:

More mobile health 24%

Greater accessibility to personal health data 29%

More effective use of technology by doctors 48%

Analytics Walkabout

Near the end of the day, attendees explored the second day with the first-ever Analytics Walkabout—45 stations showing real-life improvement stories from health systems all over the country. It was an impressive demonstration of how analytics is making a real, quantifiable difference in health systems today.